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Accepted Paper:

Paradoxes of the global and the local: reflections on rehabilitation of stroke survivors in their local community  
Paula Bronson (UCL)

Short abstract:

For LMIC, the WHO has guidelines for non-medical staff to provide locally informed health care. However, services provided by health professionals are often preferred. Global prefers the local, but the local resists. I argue that this tension would be lessened with more locally informed research.

Long abstract:

This paper will reflect on a project conducted with a small local NGO to train non-medical staff as community-based rehabilitation (CBR) workers to assist stroke survivors in gaining independence. In this region of Southeast Asia, the non-medical staff of the NGO has vigorously promoted stroke awareness through national public education programs and engagement in keeping with the World Health Organization's (WHO) CBR worker guidelines for care delivery. These are global guidelines based on local case studies to develop and implement care, emphasizing services provided by people with similar disabilities within their community within a local context. For example, in this region, there is a particularly younger-than-expected age of incidence. What are some of the causes of this? Hence, effectively researching how and what topics to deliver within local health promotion programs and how to deliver individual rehabilitation care is essential. Therefore, seeing that many chronic conditions, such as post-stroke, are best understood from the lived experience of others with similar conditions became central to WHO's ethos. Nonetheless, the local NGO contended with acceptance of the community-based model within the local and regional context. The dominant view was frequently that only healthcare professionals can provide adequate care. This paradox of a global evidence-based guideline that recommends a local community-based program is played out where the local by the local is often seen as not as beneficial.

Traditional Open Panel P216
Issues of scale: the global and the local in health research projects with a worldwide context
  Session 1